| NPI | 1457432189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TARDIF Credentialing Manager 770-801-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: GA 017200) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2008-07-18 |